Reducing Medication Administration Errors in Acute and Critical Care

Durham, Marianne L.; Suhayda, Rosemarie; Normand, Patricia; Jankiewicz, Ann; Fogg, Louis

doi:10.1097/nna.0000000000000299

Cited by 23 publications

(23 citation statements)

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“…While nursing fundamentally aims to ensure patient safety and at the very least do no harm to the patient, medication errors have become common causes of harm to patients with up to 6.5% of patients in clinical settings affected [22]. In fact a hospitalized patient typically experiences 1 medication error per day, most often during medication administration [23].…”

Section: Discussionmentioning

confidence: 99%

Nurses’ Medication Administration Errors at Medical Surgical Units

Simiyu¹

2018

AJNS

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Medication administration errors (MAEs) are among the key concepts of patient safety in clinical care settings that have long been the focus of study and exploration because they contribute directly to patient injury, death and health care costs. Medication errors are recurrent and expected to be a prolonged problem in the health care system. The administration of medication is predominantly an important part of nursing practice that has a dimension of quality of care and organizational performance. The study sought to assess nurses' medication administration errors at the general medical and surgical units. A descriptive cross sectional study design was used where stratified random sampling using the medical and surgical units as strata was used to proportionately recruit 100 Nurses. Each nurse was further observed twice during medication administration process making a total of 200 observations included in the study. Two tools were used to collect data for the current study. The interviewer administered medication administration errors questionnaire and a concealed medication administration observation checklist. Data was collected for a period of four months and analyzed using descriptive and inferential statistics to check for relations between variables. The study findings imply that the wrong rate of administration, the wrong time of administration and medication being administered after the order to discontinue was written were the highly perceived MAEs reported respectively as occurring 'most of the time' by 27%, 23% and 15% of the studied nurses. For observed MAEs, the wrong time error type had the highest estimated error rate of 51%, followed by the documentation error at 29% and technique error at 27.5%. There was statistical significant difference between the pharmacy reasons subscale of causes of MAEs and the age (F= 5.465, p=0.006), clinical experience (F=3.922, p=0.011) and type of shift (F=2.507, p=0.035) the nurse works most. Further, there was statistically significant mean differences between the medical and surgical units with regard to the medication packaging subscale (t=4.160, p=0.044). The findings also revealed negative significant correlation between the observed MAEs scores and the nurses' reported scores on types of IV & non-IV MAEs (r s =-0.266, p=0.007) and the pharmacy reasons subscale (r s =-0.266, p=0.046). Updating, developing, disseminating and implementing medication administration guidelines and protocols in the hospital settings is required. Nurses have to embrace the occurrence of MAEs as a patient safety indicator that should be viewed as an opportunity to learn and prevent MAEs through rationalized medication management protocols and guidelines.

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Section: Discussionmentioning

confidence: 99%

Nurses’ Medication Administration Errors at Medical Surgical Units

Simiyu¹

2018

AJNS

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“…As reported in the literature,[ 8 22 ] finally, 94% ( n = 94) agreed to perform a double check to verify the correct correspondence between prescription, preparation, and administration of IV drugs [ Table 4 ].…”

Section: R Esultsmentioning

confidence: 97%

Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses

Simone

Giannetta

Auddino

et al. 2018

Indian Journal of Critical Care Medicine

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Aim:The aim was to describe which elements of nurses' knowledge, training needs, behavior, and attitude can prevent Medication errors (Acronym MEs) in the emergency department during all steps of the administration of intravenous (IV) medications.Methods:An anonymous questionnaire made up of 43 items has been drafted and delivered to a sample of 103 nurses of a university hospital in Rome. The study has been supported by specific literature review.Results:Majority of the sample (94%) answered that topics related to the preparation and administration of IV medications were covered during the basic course while 63.2% only during the postbasic course. Only 15.6% of nurses judged excellent their level of knowledge about preparation and administration of IV medications while 89.3% considered that it is important to improve their knowledge; 85.6% said that the teaching about the use of IV medications should be increased during the degree course they attended; 30.3% agreed that specific postgraduate courses on the use of IV drugs should be designed. Moreover, only 22% of the sample believed that the coaching of new recruit nurses is critical to prevent errors.Conclusion:The sample showed appropriate knowledge, positive attitudes, and right behavior related to the preparation and administration of IV medications. The skills that nurses must have in pharmacology are still rising, both due to the safety of drug therapy and to the increasing number of drugs available; the result is that nurses have to update their knowledge regularly.

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“…Nurses reported using mindfulness strategies to gain situational awareness before medication administration, which in turn reduced the risk of errors (Durham, Suhayda, Normand, Jankiewicz, & Fogg, 2016).…”

Section: Why Is This Research Needed?mentioning

confidence: 99%

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

Bucknall

Fossum

Hutchinson

et al. 2019

Journal of Advanced Nursing

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Aims To describe nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in acute hospital settings. Background Medication errors cause unintended harm to patients. Nurses have a major role in ensuring patient safety in medication administration practices in hospital settings. Investigating nurses’ medication administration decision‐making and practices and their perceptions of patient involvement, may assist in developing interventions by revealing how and when to involve patients during medication administration in hospital. Design A descriptive exploratory study design. Methods Twenty nurses were recruited from two surgical and two medical wards of a major metropolitan hospital in Australia. Each nurse was observed for 4 hr, then interviewed after the observation. Data were collected over six months in 2015. Observations were captured on an electronic case report form; interviews were audio‐recorded and transcribed verbatim. Data were analysed using descriptive statistics and content and thematic analysis. Results Ninety‐five medication administration episodes, of between two and eight episodes per nurse, were observed. A total of 56 interruptions occurred with 26 of the interruptions being medication related. Four major themes emerged from the interviews: dealing with uncertainty; facilitating, framing and filtering information; managing interruptions and knowing and involving patients. Conclusion Nurses work in complex adaptive systems that change moment by moment. Acknowledging and understanding the cognitive workload and complex interactions are necessary to improve patient safety and reduce errors during medication administration. Knowing and involving the patient is an important part of a nurses’ medication administration safety strategies.

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Reducing Medication Administration Errors in Acute and Critical Care

Abstract: Strategies to support safe medication administration may reduce error and be of interest to nurse leaders.

Cited by 23 publications

References 0 publications

Nurses’ Medication Administration Errors at Medical Surgical Units

Nurses’ Medication Administration Errors at Medical Surgical Units

Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

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